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March 31, 2012BMC Endocrine Disorders89 citationsOpen Access

The association of hypertriglyceridemia with cardiovascular events and pancreatitis: a systematic review and meta-analysis

MMM. Hassan MuradAHAhmad HazemFCFernando Coto‐Yglesias

Key Result

Fasting hypertriglyceridemia is significantly associated with an increased risk of cardiovascular events (OR 1.37), cardiovascular death (OR 1.80), myocardial infarction (OR 1.31), and pancreatitis.

Study Design

Type

Meta-Analysis (n=927,218)

Structured PICO

Is fasting hypertriglyceridemia associated with an increased risk of cardiovascular events and pancreatitis?

P
Population
927,218 patients from 35 longitudinal studies followed for an average of 114 months to evaluate the association of fasting hypertriglyceridemia with cardiovascular outcomes and pancreatitis.
E
Exposure
Fasting hypertriglyceridemia
O
Outcome
Cardiovascular events and pancreatitishard clinical

Fasting hypertriglyceridemia is significantly associated with an increased risk of cardiovascular death, myocardial infarction, cardiovascular events, and acute pancreatitis.

Main Result

Odds Ratio: 1.37 (95% CI 1.23–1.53)

Limitations

  • Observational nature of the existing evidence limits causal inference
  • Potential confounding by baseline cardiovascular risk and other lipid subfractions
  • Important heterogeneity (I2 > 50%) across the meta-analytic estimates
  • Potential publication and reporting bias
  • Unclear in most studies if patients had pre-existent outcomes at baseline
  • Unclear if patients were treated with drugs that can affect triglyceride levels
  • Only one eligible study evaluated the association with acute pancreatitis
  • Moderate to low quality of included observational studies

Abstract

BACKGROUND: Hypertriglyceridemia may be associated with important complications. The aim of this study is to estimate the magnitude of association and quality of supporting evidence linking hypertriglyceridemia to cardiovascular events and pancreatitis. METHODS: We conducted a systematic review of multiple electronic bibliographic databases and subsequent meta-analysis using a random effects model. Studies eligible for this review followed patients longitudinally and evaluated quantitatively the association of fasting hypertriglyceridemia with the outcomes of interest. Reviewers working independently and in duplicate reviewed studies and extracted data. RESULTS: 35 studies provided data sufficient for meta-analysis. The quality of these observational studies was moderate to low with fair level of multivariable adjustments and adequate exposure and outcome ascertainment. Fasting hypertriglyceridemia was significantly associated with cardiovascular death (odds ratios (OR) 1.80; 95% confidence interval (CI) 1.31-2.49), cardiovascular events (OR, 1.37; 95% CI, 1.23-1.53), myocardial infarction (OR, 1.31; 95% CI, 1.15-1.49), and pancreatitis (OR, 3.96; 95% CI, 1.27-12.34, in one study only). The association with all-cause mortality was not statistically significant. CONCLUSIONS: The current evidence suggests that fasting hypertriglyceridemia is associated with increased risk of cardiovascular death, MI, cardiovascular events, and possibly acute pancreatitis.Précis: hypertriglyceridemia is associated with increased risk of cardiovascular death, MI, cardiovascular events, and possibly acute pancreatitis.

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Cite This Study

Murad et al. (2012) conducted a meta-analysis in Hypertriglyceridemia (n=927,218). Fasting hypertriglyceridemia vs. Normal or lower fasting triglyceride levels was evaluated on Cardiovascular events (OR 1.37, 95% CI 1.23-1.53). Fasting hypertriglyceridemia is significantly associated with an increased risk of cardiovascular events (OR 1.37), cardiovascular death (OR 1.80), myocardial infarction (OR 1.31), and pancreatitis.

synapsesocial.com/papers/6a229b1204258437f814a0f5https://doi.org/10.1186/1472-6823-12-2
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